In our study, 13% of patients in the derivation cohort received steroid therapy within the first 48 hours after ICU admission, which may contribute to hyperglycemia or glycemic variabilityFuture prospective studies should incorporate detailed treatment data, including insulin protocols, corticosteroid dose, and nutritional interventions, to better understand how clinical interventions shape blood glucose trajectories and long-term outcomes. The gene discussed is INS; the disease is Hyperglycemia.